Vignesh, T (2022) Correlation of Immunoglobulin (IGE) and Absolute Eosinophil Count (AEC) with Diagnostic Nasal Endoscopy in Allergic Rhinitis Patients. Masters thesis, Velammal Medical College Hospital and Research Institute, Madurai.
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Abstract
INTRODUCTION: Allergic rhinitis is an IgE-mediated allergic hypersensitivity disorder of the nasal mucous membrane that causes sneezing fits, itching in the nostril, thin watery postnasal drip, and the sensation of a blocked nose. Around 20-30percent of the total of the Indian population suffers from nasal allergies, with 15% of those suffering from bronchial asthma. Approximately one-fifth of patients who visit an ENT practitioner's outpatient clinic have allergy symptoms. Allergic rhinitis patients also experience sleep disturbances, fatigue, mood swings, and impaired higher brain processes, all of which negatively impact the patient's (QOL) quality of life and work productivity.3 These patients may also have the following, 1) Allergic conjunctivitis, 2) Posterior nasal drip, 3) Otitis media with effusion, 4) Chronic rhino sinusitis, and 5) Malocclusion of teeth and facial deformities in the paediatric age range. Household allergens such as dust mites, pets, cockroaches, and fungal moulds can cause an acute allergic reaction. Plant pollen, industrial allergens such as latex, cigarette smoke, vehicle exhaust, nitrogen oxide, and sulphur dioxide are examples of outdoor allergens. A detailed history should be followed by a clinical examination. OBJECTIVES: 1. To estimate the Serum Total IgE level in patients with Allergic Rhinitis 2. To estimate the Absolute Eosinophil Count (AEC) in patients with Allergic Rhinitis. 3. To Correlate Serum Total Immunoglobulin E Level and Absolute Eosinophil Count (AEC) with Diagnostic Nasal Endoscopic Findings in Allergic rhinitis patients. MATERIALS AND METHODS: Study Design: Cross sectional Analytical study. Study Area: Outpatient department of ENT in Velammal Medical College and research institute, Velammal Village, Madurai Study Period and Duration: 10 months (Nov 2020-Aug 2021). Study Population: Allergic rhinitis based on typical history and clinical features in the age group 10 to 60 -years-old attending outpatient department of ENT in Velammal Medical College and research institute, Madurai. Sample Size Calculation: Reported incidence of allergic rhinitis in India also ranges between 20% and 30% and it was mentioned by Chandrika in her study. 15 The sample size was calculated with a confidence interval of 95%. Anticipated proportion of allergic rhinitis according to similar studies conducted in India was 30% and with the total width of confidence interval being 0.09, the sample size for the normal approximation of binomial calculation was 100. CONCLUSION: The average age of the study participants was 31.42 10.433, with a range of 11 to 57 years. Males made up about 33% of the study participants, while females made up the remaining 67%. The mean Absolute Eosinophil Count of the study participants was 340.22 182.07, with a range of 100 to 1200. The study participants' average Immunoglobulin levels were 1239.25 1238.21, with a range of 47 to 4560. The most common complaint was nasal blockage. ❖ Cronbach's alpha score for the total score of the Modified Lund Kennedy Endoscopy finding and if any of the items were eliminated was 0.764, which is higher than 0.7. (good consistency). This scale has been proven to be reliable for data collection. The Modified Lund Kennedy Endoscopy total score has a high positive association with Absolute eosinophil count and Immunoglobulin E level, according to spearman's rank correlation. ❖ The higher variability in Allergic rhinitis scoring attributed to the MLK system's improved dependability over the LK system. Although various other endoscopic scoring systems have been proposed to replace the Lund-Kennedy scoring system in order to increase reliability and clinical correlation, the MLK system appears to meet these goals. The MLK method may be well suited for use in both clinical practise and outcomes research due to its ease of use, applicability to patients regardless of surgery status, and improved correlations with AEC and IGE level. LIMITATIONS: ❖ Because the sample was selected from hospital patients, the results cannot be applied to the entire population. ❖ This is an observational study; a more experimental design with a Randomized Controlled Trial would allow for a more accurate comparison. ❖ There is no control or comparison group with other types of DNE scoring tools such as the Lund-Mckay score, DIP, and so on. ❖ The sample size is rather small. RECOMMENDATIONS: This study suggests that nasal endoscopy be utilised as an early diagnostic technique for suspected Allergic rhinitis patients (based on diagnostic symptom criteria), particularly in hospitals with limited resources, high patient loads, and limited healthcare budgets. DNE, namely the Modified Lund Kennedy system, aids in reducing CT usage, lowering costs and reducing radiation exposure. As a result, we can diagnose and treat most patients with allergic rhinitis based on symptoms and DNE findings. Although CT is a more favourable tool for diagnosing the proper extent of the disease, the implicated sinuses, and the severity of the disease in each sinus in specialty care centres with CT availability. Despite maximum treatment, computed tomography may be added in patients with anatomical problems impairing endoscopic visibility, patients scheduled for surgery, and those with refractory disease. ❖ Many variables (e.g., smoking history, allergies, co-morbidities, quality of life, treatment) that could have influenced our patients' outcomes were not included in this study. ❖ Only blood samples were taken, when nasal smears would have provided a more accurate result.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 220420508002 |
| Uncontrolled Keywords: | Correlation, Immunoglobulin (IGE), Absolute Eosinophil Count (AEC), Diagnostic Nasal Endoscopy Allergic Rhinitis Patients. |
| Subjects: | MEDICAL > Otolaryngology > MEDICAL > Otolaryngology |
| Depositing User: | Thavamani K |
| Date Deposited: | 04 Aug 2022 07:31 |
| Last Modified: | 17 Dec 2023 15:44 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/20691 |
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